Treatment of shift work disorder and jet lag

Zee, Phyllis C.; Goldstein, Cathy A.

doi:10.1007/s11940-010-0090-9

Cited by 79Sleep and Work-Related FatigueCircadian rhythm and melatoninSleep and related disorders

Treatment of shift work disorder and jet lag

Zee, Phyllis C., Goldstein, Cathy A.·2010·Current Treatment Options in Neurology

DOI 10.1007/s11940-010-0090-9

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Abstract

Opinion statement With the growth of the 24-hour global marketplace, a substantial proportion of workers are engaged in nontraditional work schedules and frequent jet travel across multiple time zones. Thus, shift work disorder and jet lag are prevalent in our 24/7 society and have been associated with significant health and safety repercussions. In both disorders, treatment strategies are based on promoting good sleep hygiene, improving circadian alignment, and targeting specific symptoms.Treatment of shift work must be tailored to the type of shift. For a night worker, circadian alignment can be achieved with bright light exposure during the shift and avoidance of bright light (with dark or amber sunglasses) toward the latter portion of the work period and during the morning commute home. If insomnia and/or excessive sleepiness are prominent complaints despite behavioral approaches and adequate opportunity for sleep, melatonin may be administered prior to the day sleep period to improve sleep, and alertness during work can be augmented by caffeine and wake-promoting agents.For jet lag, circadian adaptation is suggested only for travel greater than 48 h, with travel east more challenging than travel west. Although advancing sleep and wake times and circadian timing for eastward travel with evening melatonin and morning bright light several days prior to departure can help avoid jet lag at the new destination, this approach may be impractical for many people, Therefore, strategies for treatment at the destination, such as avoidance of early morning light and exposure to late-morning and afternoon light alone or in conjunction with bedtime melatonin, can accelerate re-entrainment following eastward travel. For westward travel, a circadian delay can be achieved after arrival with afternoon and early-evening light with bedtime melatonin.Good sleep hygiene practices, together with the application of circadian principles, can improve sleep quality, alertness, performance, and safety in shift workers and jet travelers. However, definitive multicenter randomized controlled clinical trials are still needed, using traditional efficacy outcomes such as sleep and performance as well as novel biomarkers of health.

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Multiple studies, opinions, and guidelines have suggested melatonin as primary therapy for improved health and sleep of shift workers.
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From Is Melatonin the “Next Vitamin D”?: A Review of Emerging Science, Clinical Uses, Safety, and Dietary Supplements (2022) · cites this paper as [70]

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Efficacy and safety of supplemental melatonin for delayed sleep–wake phase disorder in children: an overview
Mantle, D., Smits, M. G., Boss, M., Miedema, I., & van Geijlswijk, I. M. (2020) · Sleep Medicine X · doi:10.1016/j.sleepx.2020.100022 · Cited by 41 · see citing works
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The effectiveness of an individualized sleep and shift work education and coaching program to manage shift work disorder in nurses: a randomized controlled trial
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Sleep and fatigue management strategies: How nurses, midwives and paramedics cope with their shift work schedules—a qualitative study
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Pineal melatonin level disruption in humans due to electromagnetic fields and ICNIRP limits
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Dopamine Signaling in Circadian Photoentrainment: Consequences of Desynchrony.
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“The recommendations with avoidance of bright light toward the latter portion of the work period and during the morning commute home would not be for rapidly rotating shift workers.(29,30) The total activity level during working hours was not different among the shift schedules.”
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“Pharmacological sleep aids are also indicated for use in SWD for the management of sleep problems (Morgenthaler et al. 2007; Zee and Goldstein 2010).”
Background
Preliminary Exploration into the Impact of Mistimed Expressed Breast Milk Feeding on Infant Sleep Outcomes, Compared to Other Feeding Patterns
Booker, L. A., Spong, J., Deacon‐Crouch, M., & Skinner, T. C. (2022) · Breastfeeding Medicine · doi:10.1089/bfm.2022.0125 · Cited by 9 · see citing works
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“As a sequel to that, shift work impairs concentration, elevates nervousness, mental and physical fatigue, thus further strengthening the manifestations of chronic psychiatric stress [18, 19].”
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A time and a place: A framework for caffeine periodization throughout the sporting year
Pickering, C., & Grgić, J. (2020) · Nutrition · doi:10.1016/j.nut.2020.111046 · Cited by 8 · see citing works
Pollution de l’horloge interne par la lumière la nuit, un problème de santé publique
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Sleep Medicine Pharmacotherapeutics Overview
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How Light Resets Circadian Clocks
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Circadian Timing: From Genetics to Behavior
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“…the alternation between a normal sleep/wake cycle and being awake at night and sleeping during the day not only alters the light/dark schedule in relation to the endogenous circadian clock, but also modifies feeding patterns, social habits, etc. (Reid & Abbott, 2015; Zee & Goldstein, 2010).”
Background
The Effects of Circadian Rhythm Disruption towards Metabolic Stress and Mental Health: A Review
Tharumalay, R. D., Din, N. S. B. M., & Ahmad, M. (2020) · Jurnal Sains Kesihatan Malaysia · doi:10.17576/jskm-2020-1801-07 · Cited by 6 · see citing works
Performance of wearable light sensors for measuring photopic and melanopic illuminance under laboratory and free-living conditions
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Effects of Circadian Disruption on Physiology and Pathology: From Bench to Clinic (and Back)
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Kim, R., Fang, Y., Lee, M., Kim, D. W., Tang, Z., Sen, S., & Forger, D. B. (2025) · npj Digital Medicine · doi:10.1038/s41746-025-01678-z · Cited by 3 · see citing works
“Variousjetlagandshiftworkdisordertreat-ment approaches aim to speed up entrainment of circadian rhythms to external cues 58 .”
Chronodisruption and Obesity
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Shift Work and Shift Work Sleep Disorders: Definition, Symptoms and Treatment
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“Çok nadir olmakla beraber, görülebilecek yan etkiler arasında irritabilite, baş ağrısı, bulantı, çift görme, fotofobi, hipomani semptomları bulunmaktadır (33).”
Influential
Acute and long‐term sleep measurements produce opposing results on sleep quality in 8 and 12 hour shift patterns in law enforcement officers
Sharma, L., Pedlar, C. R., Burgess, P. W., Kanagasabai, S., & Ronca, F. (2023) · Journal of Sleep Research · doi:10.1111/jsr.13862 · Cited by 2 · see citing works
“The study also supports the need for education on sleep hygiene practices in order to optimise sleep quality (Garbarino et al., 2019; Zee & Goldstein, 2010).”
Molecular Genetic Mechanisms of Circadian Rhythm Regulation and Their Role in Psychopathology
Smirnova, K. V., Chizhova, N. D., Gerasimova, E., Kalueff, A. V., & Amstislavskaya, T. G. (2023) · Journal of Evolutionary Biochemistry and Physiology · doi:10.1134/s0022093023060121 · Cited by 2 · see citing works
Molecular Genetic Mechanisms of Circadian Rhythm Regulation and Their Role in Psychopathology
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Insomnia in ambulatory care: A clinical review
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Understanding aircrew circadian resynchronization following time zone flights
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The effect of fatigue on seafarers’ ship-boarding process: jet lag disorder
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“Zee and Goldstein [25] identified jet lag disorder as symptoms of insomnia and/or excessive daytime sleepiness caused by traveling in at least two time zones.”
Temporal control at work: Qualitative time and temporal injustice in the workplace
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An empirical study investigating pilot sleep recovery patters after different time zone flights
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Adrenal glucocorticoids as a target for jet lag therapies
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Central and peripheral clocks synergistically enhance circadian robustness, flexibility and performance of cardiac pacemakingPreprint
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Influence of Morningness Orientation in Cognitive Performance in School Girls (Age 11 To 14)
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Using night shift worker and employee health stakeholder perspectives to inform the development of Arcashifttm, a digital precision circadian medicine intervention for shift work disorder
Coyne, P., Jennings, M. B., Santarossa, S., Murphy, D., Zreik, M., Bryans, H., Drake, C. L., Walch, O., & Cheng, P. (2025) · BMC Digital Health · doi:10.1186/s44247-025-00167-3
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JET-LAG SENDROMUNUN İŞ VE İŞLETME PERFORMANSI ÜZERİNDEKİ ETKİSİ
Deni̇z, A. (2026) · Yönetim Bilimleri Dergisi · doi:10.35408/comuybd.1656833

Authors: Zee, P. C., & Goldstein, C. A.
Corresponding author: Goldstein, Cathy A.
ORCID: Zee, Phyllis C.
Goldstein, Cathy A.
Venue: Current Treatment Options in Neurology
Publisher: Springer Science and Business Media LLC
Published: 2010-07-20
Volume: 12
Issue: 5
Pages: 396-411
ISSN: 1092-8480 (ISSN-L)
1534-3138
DOI: 10.1007/s11940-010-0090-9
OpenAlex: W2075473818
Cited by: 79
References: 65
Citations by year: 2026: 2 · 2025: 7 · 2024: 4 · 2023: 4 · 2022: 4 · 2021: 7 · 2020: 6 · 2019: 5 · 2018: 7 · 2017: 6 · 2016: 3 · 2015: 3 · 2014: 5 · 2013: 5 · 2012: 5
FWCI: 6.70
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: Current Treatment Options in Neurology (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Keywords: shift work disorder, jet lag, circadian rhythm, melatonin, bright light exposure, sleep hygiene, caffeine, excessive sleepiness, insomnia, shift work

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Treatment of shift work disorder and jet lag

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